Female sex, higher blood pressure, and diabetes attenuate normal age-related cardiac remodeling, potentially explaining their strong association with diastolic heart failure.
Cardiac remodeling over the adult life course is characterized by a distinct pattern of increasing LV wall thickness, decreasing LV dimensions, and increasing fractional shortening with advancing age. Overall, female sex, greater blood pressure load, and presence of diabetes mellitus serve to attenuate this remodeling pattern. These observations suggest a mechanism for the preponderance of women with hypertension and individuals with diabetes among patients with diastolic heart failure.
Cheng et al. (Tue,) studied this question.